Differentiating suicide attempters from suicide ideators using the Integrated Motivational–Volitional model of suicidal behaviour

Dhingra, Katie; Boduszek, Daniel; O’Connor, Rory C.

doi:10.1016/j.jad.2015.07.007

Cited by 140 publications

(108 citation statements)

References 47 publications

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“…Anxious and avoidant dimensions of attachment were also correlated with suicidal thinking as suggested by other studies (e.g., Aaltonen et al, ; Falgares et al, ; Park et al, ). Although Nunes and Mota () suggested that attachment would be the main mediator of the relationship between parenting and suicidal ideation, we understand that suicidal ideation formation involves the core psychological states of defeat and entrapment as proposed by the IMV model and supported by previous studies (e.g., Dhingra et al, , ; Owen et al, ; Wetherall et al, ). Therefore, we found that the relationships between perceptions of past parenting and suicidal ideation, and insecure forms of attachment and suicidal ideation are mediated by defeat and entrapment (panels a–c of Figure ).…”

Section: Discussionsupporting

confidence: 79%

“…These volitional moderators include impulsivity, access to lethal means, planning, exposure to suicide, impulsivity, physical pain sensitivity, fearlessness about death, imagery, and previous suicide attempts. There is increasing evidence for the paths and processes outlined in the IMV model (Dhingra et al, ; Forkmann et al, ; O’Connor, ; O’Connor & Portzky, ; O’Connor et al, ; Rasmussen et al, ; Taylor et al, ; Wetherall et al, ).…”

Section: Introductionmentioning

confidence: 99%

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Perceptions of Past Parenting and Adult Attachment as Vulnerability Factors for Suicidal Ideation in the Context of the Integrated Motivational–Volitional Model of Suicidal Behavior

Zortea

Gray

O’Connor

2019

Suicide & Life Threat Behav

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Objective We aimed to investigate whether perceptions of past parenting and current attachment orientations are associated with key components of the Integrated Motivational–Volitional (IMV) Model of Suicidal Behavior. We investigated the relationship between perceptions of past parenting, attachment, suicide ideation, defeat, entrapment, coping, and resilience. Method A total of 730 adult participants responded to an online questionnaire comprised of psychological measures. An initial regression analysis indicated that memories of past parenting and attachment were associated with suicide ideation. Four mediation models were tested based on the IMV model, all controlling for depressive symptoms. Results In the first model, attachment orientations mediated the relationships between perceptions of past parenting dimensions and defeat. In the second, defeat mediated the relationships between attachment orientations and entrapment. In the third, entrapment mediated the relationship between defeat and suicidal ideation, but coping did not moderate the defeat–entrapment relationship. In the final model, entrapment mediated the relationship between defeat and suicide ideation, with resilience moderating this relationship. Conclusions The findings are novel and congruent with the core principles of the IMV model. Clinical implications suggest the protective effect of resilience and strengthening of self‐compassion attitudes to reduce the effect of insecure attachment strategies.

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Section: Discussionsupporting

confidence: 79%

Section: Introductionmentioning

confidence: 99%

Perceptions of Past Parenting and Adult Attachment as Vulnerability Factors for Suicidal Ideation in the Context of the Integrated Motivational–Volitional Model of Suicidal Behavior

Zortea

Gray

O’Connor

2019

Suicide & Life Threat Behav

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“…In the present context, an if situation could be “if I want to get relief from a terrible state of mind” and the then response would be an alternative to self-harm (eg, “…then I will think about the effect of my self-harming on the people around me”) that should make the participant more likely to choose a solution other than self-harm. According to the IMV model, implementation intentions are volitional moderators that can reduce (or increase) the likelihood of people acting on their self-injurious thoughts 12, 20…”

Section: Introductionmentioning

confidence: 99%

A brief psychological intervention to reduce repetition of self-harm in patients admitted to hospital following a suicide attempt: a randomised controlled trial

O’Connor

Ferguson

Scott

et al. 2017

The Lancet Psychiatry

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SummaryBackgroundWe investigated whether a volitional helpsheet (VHS), a brief psychological intervention, could reduce repeat self-harm in the 6 months following a suicide attempt.MethodsWe did a prospective, single-site, randomised controlled trial. Patients admitted to a hospital in Edinburgh, UK, after a suicide attempt were deemed eligible for the study if they were over the age of 16 years, had a self-reported history of self-harm, were fluent in English, were medically fit to interview, and were not participating in other research studies within the hospital. Eligible patients were randomly assigned (1:1), via web-based randomisation, to receive either VHS plus usual treatment (intervention group) or only treatment as usual (control group). Randomisation was stratified by sex and self-reported past self-harm history. The Information Services Division of the National Health Service (NHS-ISD) staff and those extracting data from medical notes were masked to the study group the participant was allocated to. Clinical staff working within the hospital were also masked to participants' randomisation status. There were three primary outcomes: the proportion of paticipants who re-presented to hospital with self-harm during the 6-month follow-up period; the number of times a participant re-presented to hospital with self-harm during the 6-month follow-up period; and cost-effectiveness of the VHS as measured by estimated incremental cost per self-harm event averted. Primary outcomes were analysed in all randomised patients. Follow-up data collection was extracted from the Information Services Division of the NHS and from patient medical records. The trial is registered with International Standard Randomised Controlled Trial Number Registry, number ISRCTN99488269.FindingsBetween May 9, 2012, and Feb 24, 2014, we assessed 1308 people for eligibility. Of these, 259 patients were randomly assigned to the intervention group and 259 to the control group. We obtained complete follow-up data on 512 (99%) of 518 patients (five participants were lost to follow-up in the intervention group and one in the control group). 11 patients assigned to the intervention group did not complete the VHS in hospital. Overall, the intervention did not affect the number of people who re-presented with self-harm (67 [26%] of 254 patients in the intervention group vs 71 [28%] of 258 patients in the control group, odds ratio [OR] 0·90, 95% CI 0·58–1·39, p=0·63). The intervention had no effect on the number of re-presentations per patient (mean 0·67 [SD 2·55] re-presentations for the intervention group vs 0·85 [2·79] for the control group, incident rate ratio [IRR] 1·65, 95% CI 0·74–3·67, p=0·21). Mean total costs per person for NHS hospital services in the VHS intervention group over the 6 months were £513 versus £561 in the control group but this difference was not significant (95% CI–£353 to £257, p=0·76). Three patients died by suicide in the 6 months following their index suicide attempt (one in the intervention group and two in the control ...

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“…Third, the highest risk of suicide attempt is in the first year after onset of ideation, whether or not a plan has been made (Nock et al, 2008). Fourth, process models of suicide attempt, that posit suicide as a continuum of risk from suicide ideation to suicide plan to suicide attempt (Crosby et al, 1999; Kessler et al, 1999; LeMaster et al, 2004), have not adequately explained the relationship between first-time suicide ideation and suicide attempt and have failed to identify which suicide ideators are at greatest risk for becoming suicide attempters (i.e., acting on such thoughts) (Dhingra, Boduszek, & O’Connor, 2015). Further, approximately one third of American adults who report previous suicide attempts deny having prior suicide ideation or suicide plan (Crosby et al, 1999; LeMaster et al, 2004).…”

Section: Discussionmentioning

confidence: 99%

Substance Use Disorders and Poverty as Prospective Predictors of Adult First-Time Suicide Ideation or Attempt in the United States

Thompson

Alonzo

et al. 2016

Community Ment Health J

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This study examined whether substance use disorders and poverty predicted first-time suicide ideation or attempt in United States national data. Respondents without prior histories of suicide ideation or attempt at Wave 1 of the NESARC (N=31,568) were analyzed to determine the main and interactive effects of substance use disorders and poverty on first-time suicide ideation or attempt by Wave 2, three years later. Adjusted for controls, poverty (AOR=1.35, CI=1.05–1.73) and drug use disorders (AOR=2.10, CI=1.07–4.14) independently increased risk for first-time suicide ideation or attempt at Wave 2. SUD and poverty did not interact to differentially increase risk for first-time suicide ideation or attempt, prior to or after adjustment for controls. This study reinforces the importance of substance use disorders and poverty in the risk for first-time suicide ideation or attempt. Public health efforts should target messages to drug users and the impoverished that highlight their increased risk for first-time suicide.

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Differentiating suicide attempters from suicide ideators using the Integrated Motivational–Volitional model of suicidal behaviour

Abstract: Background. Suicidal behaviour is a significant public health concern, yet little is known

Cited by 140 publications

References 47 publications

Perceptions of Past Parenting and Adult Attachment as Vulnerability Factors for Suicidal Ideation in the Context of the Integrated Motivational–Volitional Model of Suicidal Behavior

Perceptions of Past Parenting and Adult Attachment as Vulnerability Factors for Suicidal Ideation in the Context of the Integrated Motivational–Volitional Model of Suicidal Behavior

A brief psychological intervention to reduce repetition of self-harm in patients admitted to hospital following a suicide attempt: a randomised controlled trial

Substance Use Disorders and Poverty as Prospective Predictors of Adult First-Time Suicide Ideation or Attempt in the United States

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